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International Journal of Hepatology
Volume 2011, Article ID 790232, 7 pages
http://dx.doi.org/10.4061/2011/790232
Review Article

Management of Renal Failure and Ascites in Patients with Cirrhosis

Medanta Institute of Digestive and Hepatobiliary Sciences, Medanta-The Medicity Hospital, Sector 38, Gurgaon, Haryana 122001, India

Received 20 April 2011; Accepted 13 June 2011

Academic Editor: Deepak Amarapurkar

Copyright © 2011 Kaushal Madan and Ashish Mehta. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Ascites and renal dysfunction in cirrhosis occur when the liver disease is decompensated and signify the presence of advanced liver failure. However, the precipitating causes should be looked for and treated. Although liver transplantation is the treatment of choice in patients with advanced liver failure, mild to moderate ascites can be treated effectively with medical management. Similarly, renal failure in cirrhotics is reversible if the precipitating causes can be treated effectively and by use of combination of vasoconstrictors and albumin. Transjugular intrahepatic portosystemic shunts also offer an effective therapy for refractory ascites and HRS. Such treatments may offer effective bridge to liver transplantation, by improving short and medium term survivals. Here, we shall discuss all the options available for the management of these complications of cirrhosis.